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1-- 2008 Employee Benefit Plan Review and Recommendations February 13,2008 is both a decrease in potential coverage and could be a significant difference in benefit for employees who experience some sort of catastrophic health situation. . Substance abuse benefit - The proposed Humana HMO plan includes a lifetime maximum benefit of $2,000 for substance abuse treatment. The current United Healthcare HMO plan limits substance abuse treatment in the same manner as other mental health services, pre-authorization is required, 30 outpatient visits are allowed each year subject to a copayment of $15 and 30 days of inpatient treatment are allowed each year subject to an inpatient copayment of $250. We consider this to be a significant decrease in coverage for both employees and their families. . Network differences - As with any change in insurers for a medical plan, while the Humana network is adequate, whenever a change occurs, some employees and their families will be affected and would need to change physicians. For example, we have been advised that Dr. Luisa Sztern, one of the most utilized physicians for City employees and their families, is not on the Humana network of physicians. Further, there are concerns that Humana's networks will not provide adequate coverage for employees with dependents living out of area, such as college students, or retirees living out of area. In our opinion, the proposed alternate plans from Aetna, CIONA and Humana do not meet the City's previously noted renewal goal of not significantly impacting employees. UNITED HEAL THCARE RENEWAL OPTIONS At Brown & Brown's direction, United Healthcare offered eight (8) plan design alternatives to the currently elected HMO/POS dual options, Of these alternatives, all included plan designs with reductions in benefits through either increased copayments and/or increased deductibles for employees and their families when health care services and prescriptions are needed. It is understood that additional options with differing combinations of increased copayments and deductibles are available, Two of the alternatives offered were through Neighborhood Health Plan, an HMO owned by United Healthcare, with a different network centered in South Florida, It is understood that the provider networks for the Neighborhood Health Plan, while limited to the Miami-Dade, Broward and Palm Beach areas, are substantial and include most of the United Healthcare providers in South Florida and additional providers. Since the Neighborhood Health Plan option will not replace the United Healthcare plans, employees will have a choice between the United Healthcare plan with a national provider network or the Neighborhood Health Plan with the more limited local network. Page 4